金黄色葡萄球菌3年耐药性变迁研究

Variation of Drug Resistance of Staphylococcus aureus in 3 Years

目的分析医院2003年11月-2006年10月金黄色葡萄球菌耐药性的变化,为临床合理选用抗菌药物提供依据。方法收集临床标本中分离的金黄色葡萄球菌菌株,采用K-B纸片扩散法,判断标准均按NCCLS(2002年)规定标准判定结果。结果痰、伤口分泌物为金黄色葡萄球菌的主要标本来源,ICU及内科病房为金黄色葡萄球菌的主要病区,5年间,除糖肽类药物外,耐甲氧西林金黄色葡萄球菌(MRSA)对各类药物的耐药率均很高,显著高于MSSA(P<0.05);在金黄色葡萄球菌耐药性动态观察中发现,16种测试药物的耐药率在3年间并无明显的变化,除氯霉素、万古霉素、替考拉宁外,其他药物耐药率均>50%,且表现为多药耐药。结论3年间金黄色葡萄球菌的耐药率持续保持较高的水平,并且MRSA的检出率有逐年上升的趋势,要求临床要合理使用抗菌药物,并动态监测其耐药性的变迁。

OBJECTIVE To analyze the variation of drug resistance of Staphylococcus aureus （SA） in our hospital during from Nov 2003 to Oct 2006,as the basis for clinical antibiotics application. METHODS To collect the SA strains isolated from clinical samples in our hospital, and adopt the diffusion method of Kirby-Bauer method, then assess the result according to NCCLS in 2002. RESULTS Sputum and excreta were the main specimen sources of SA. ICU and medical wards were the main endemic area of SA. Besides glycopeptides drugs,MRSA remained its high drug resistance rate to other drugs,and exceeded MSSA significantly （P〈0.05）. In the dynamic observation of drug resistance of SA, we had discovered that there was no conspicuous variation of drug resistance rate to sixteen kinds of test drugs during the last three years. Except for chloramphenicol, vancomycin and teicoplanin,. the resistance rate to other drugs exceeded 50%, and presented multidrug resistant. CONCLUSIONS Drug resistance rate of SA continues to keep higher level during the last three years,and moreover the detection rate of MRSA keeps an ascendant tendency year by year. It is essential for clinic to rational use of antibiotics, and dynamic observation of varying drug resistance.